I flush really easily, including “blushing because I feel I’m blushing already” (once I start, it’s a downward spiral). This leads to unfortunate experiences like my thesis defense, in which I was an embarrassing shade of hot pink for the entire period. Thankfully, I know this is not an affliction I suffer alone. Everyone blushes, so we all know how blushing feels. Now imagine that sensation constantly and times it by a thousand – that’s what having rosacea would feel like. I fear with my many blushing triggers, I could easily develop rosacea in the near future. So what is rosacea and how is it treated?
Rosacea is a chronic inflammatory condition that mostly affects those of fair-skin, northwestern European descent and over the age of thirty. Though rosacea is characterized by redness starting on the central face and spreading across the face, forehead and neck (sometimes even further), symptoms may worsen with age and without treatment, leading to permanent redness, burning, stinging, dilation and breaking of superficial blood vessels (telangiectasia), lesions (papules and pustules), red eyes and the characteristic red, lobulated nose (rhinophyma). The exact cause of rosacea has not been delineated, but scientists believe that the triggers we associate with flushing may be important in the development of rosacea. Factors attributed to rosacea, as found in a survey by the National Rosacea Society, include: temperature extremes, sun exposure, alcohol, stress, foods high in histamines (molecules that dilate our blood vessels) including spicy food, red wine, cheese and cured meat, and even certain skin care regimens/treatments such as microdermabrasion, chemical peels, steroids and high doses of vitamin A (retinoids).
Treatment of rosacea varies depending on the specific type. For mild cases, no medical intervention is necessary. Patients will avoid their “triggers” and cover the occasional redness with cosmetics. For more severe cases of rosacea there are more stringent treatments available. Medical professionals gauge the success of such treatments by measuring their ability to alleviate the symptoms of rosacea – decreased redness (erythema), decreased inflammation (and associated lesions), decreased itch/burn, decreased number of flares and duration of flares etc. Often the first line of management consists of oral or topical antibiotics to treat the lesions, inflammation and redness caused by bacteria infiltrating into broken skin. More drastic measures include chemical peels with alpha-hydroxy acid (to reduce redness and irritation), broad spectrum lasers such as IPL (intense-pulsed light) which are currently the best option to reduce redness, and CO2 lasers to remove excess tissue deposited in cases such as phymatous rosacea. Though there are many options for rosacea treatment, they are all unsatisfactory in that they cannot cure rosacea.
Fortunately there are also dermatologist-approved home remedies that can be applied to any flare-up, any time and won’t break the bank. Dr. Marmur suggests using pineapple and cottage cheese to reduce redness and the accompanying itching/burning/tender sensation. Her recipe is as follows:
1 cup cottage cheese
¼ cup pineapple (minced with some rind)
Mix together and make sure the mixture isn’t too watery (or else it’s just going to make a mess and fall off your face),
Place mixture over areas of redness,
Over the facial, put a washcloth soaked in cooled green tea,
Repeat for 10 minutes a day, twice a week, for one month.
Pineapple contains vitamins (such as vitamin C) and enzymes that rejuvenate skin, decreasing the redness as new skin cells replace those damaged by rosacea. Funnily enough, it’s the rind that actually contains the most beneficial nutrients (so don’t forget to add some of that to your rosacea-busting mixture). Cottage cheese has properties exactly like milk; they both calm irritation and moisturize skin (think fat content). In addition, cottage cheese contains essential nutrients, such as selenium, that combat dry, flaky skin, but also may protect against skin cancer! Furthermore, the basicity of cottage cheese neutralizes the acidity of the pineapple so you don’t end up making matters worse by giving yourself a “pineapple-facial-burn”. As I have mentioned in a previous blog post, green tea contains caffeine, which livens up skin. Green tea also contains antioxidants to mop up any free radicals that may be lying around.
The nickname, “Curse of the Celts” is debatable as rosacea is a skin condition that also affects many people of non-Celtic descent. Though rosacea is not yet curable, there are many treatment options than may be used to reduce and alleviate symptoms including Dr. Marmur’s helpful pineapple/cottage cheese remedy (which can also be used as a good breakfast if there’s leftover after the facial is applied). Even though rosacea may be an irritating skin condition to live with, think of this – if Diane Keaton and Miranda from “Sex and the City” can be as fabulous as they are with rosacea, there’s hope for all the easy blushers and flushers out there.
Margit Lai Wun Juhasz
Mount Sinai Medical Student